Daijiworld Media Network – New Delhi
New Delhi, Dec 26: A multicentre retrospective study has found that chronic spontaneous urticaria (CSU) occurring in patients with systemic lupus erythematosus (SLE) does not indicate increased lupus disease activity, but may be associated with specific clinical and immune features.
Researchers analysed data from 40 patients diagnosed with both SLE and CSU and compared them with 160 age- and sex-matched SLE patients without CSU. The study examined epidemiological characteristics, the timing of CSU onset in relation to lupus activity, and possible risk factors for the coexistence of the two conditions.
To determine whether CSU reflected worsening lupus, investigators compared Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores before and after the onset of CSU. They also assessed disease activity at the time of SLE diagnosis, along with differences in clinical manifestations, laboratory findings and treatments between the two groups.
The study found that the appearance of CSU did not coincide with an increase in SLEDAI scores, indicating that CSU was not a marker of heightened lupus activity in the patients studied. Researchers cautioned clinicians against assuming a lupus flare solely based on the presence of chronic urticaria, advising that skin symptoms should be interpreted alongside other clinical and laboratory indicators.
While overall lupus activity was similar in both groups, certain features were more common among patients with both SLE and CSU. Univariate analysis showed differences in cylindruria, elevated immunoglobulin levels (IgM, IgA and IgG), serositis, mucosal ulcers and the presence of anti-Pm-Scl antibodies.
Further multivariate analysis identified four factors independently associated with the occurrence of CSU in SLE patients: cylindruria, elevated IgA levels, elevated IgG levels and mucosal ulcers.
The researchers concluded that SLE patients with chronic spontaneous urticaria may represent a distinct comorbidity pattern characterised by specific immune and clinical features, rather than more severe systemic disease. They suggested that such patients may benefit from focused evaluation of urinary abnormalities, immunoglobulin levels and mucosal involvement.